Table II.
Survey Items Focusing on Inpatient Blood Pressure (BP) Control and Care Transitions
| Internal Medicine N (%) | Family Medicine N (%) | Surgery N (%) | Overall N (%) | |
|---|---|---|---|---|
| Controlling BP in the hospital is: | ||||
| (Not important) 1 | 0 (0) | 0 (0) | 0 (0) | 0 (0) |
| 2 | 5 (4.2) | 1 (3.2) | 2 (6.5) | 8 (4.5) |
| 3 | 23 (19.3) | 3 (9.7) | 3 (9.7) | 29 (16.0) |
| 4 | 53 (44.5) | 15 (48.4) | 18 (58.0) | 86 (47.5) |
| (Very important) 5 | 38 (31.9) | 12 (38.7) | 8 (25.8) | 58 (32.0) |
| I routinely retake the BPs myself in my hospitalized patients. | ||||
| (Never) 1 | 20 (16.8) | 13 (43.3) | 6 (19.4) | 39 (21.7) |
| 2 | 61 (51.3) | 13 (43.3) | 17 (54.8) | 91 (50.6) |
| 3 | 28 (23.5) | 4 (13.4) | 6 (19.4) | 38 (21.1) |
| 4 | 9 (7.6) | 0 (0) | 2 (6.4) | 11 (6.1) |
| (All patients) 5 | 1 (0.8) | 0 (0) | 0 (0) | 1 (0.5) |
| In evaluating BP, I routinely relate the timing of BP measurements to the time medications are given to my patients. | ||||
| (Never) 1 | 0 (0) | 3 (10.0) | 0 (0) | 3 (1.8) |
| 2 | 15 (13.6) | 4 (13.3) | 3 (11.5) | 22 (13.2) |
| 3 | 31 (28.2) | 9 (30.0) | 10 (38.5) | 50 (30.1) |
| 4 | 53 (48.2) | 13 (43.3) | 13 (50.0) | 79 (47.6) |
| (All patients) 5 | 11 (10.0) | 1 (3.4) | 0 (0) | 12 (7.3) |
| In what percentage of patients on your service do you adjust medications to reduce their BP while the patient is in the hospital? | ||||
| <20% | 14 (11.8) | 2 (6.5) | 4 (12.9) | 20 (11.0) |
| 20%–50% | 45 (37.8) | 10 (32.2) | 14 (45.2) | 69 (38.1) |
| 50%–80% | 44 (37.0) | 11 (35.5) | 7 (22.6) | 62 (34.3) |
| >80% | 16 (13.4) | 8 (25.8) | 6 (19.3) | 30 (16.6) |
| At what level of BP do you initiate medication changes while the patient is in the hospital? (mean, standard deviation) | ||||
| Systolic BP (mm Hg) | ||||
| 140–149 | 34 (28.6) | 11 (35.5) | 2 (6.5) | 47 (26.0) |
| 150–159 | 20 (16.8) | 6 (19.4) | 6 (19.3) | 32 (17.7) |
| 160–169 | 21 (17.7) | 8 (25.8) | 14 (45.2) | 43 (23.7) |
| 170–179 | 13 (10.9) | 1 (3.2) | 5 (16.1) | 19 (10.5) |
| 180+ | 6 (5.0) | 1 (3.2) | 1 (3.2) | 8 (4.4) |
| No specific number (% of respondents) | 25 (21.0) | 4 (12.9) | 3 (9.7) | 32 (17.7) |
| Diastolic BP (mm Hg) | ||||
| 90–99 | 54 (45.4) | 17 (54.8) | 6 (19.4) | 77 (42.5) |
| 100–104 | 16 (13.5) | 7 (22.6) | 15 (48.4) | 38 (21.0) |
| 105–109 | 13 (10.9) | 1 (3.2) | 2 (6.5) | 16 (8.8) |
| 110–114 | 1 (0.8) | 1 (3.2) | 2 (6.5) | 4 (2.2) |
| 115+ | 0 (0) | 0 (0) | 1 (3.2) | 1 (0.6) |
| No specific number (% of respondents) | 35 (29.4) | 5 (16.1) | 5 (16.1) | 45 (24.9) |
| I base my decisions regarding medications to reduce BP on the Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC 7) guideline recommendations. | ||||
| Yes | 83 (69.8) | 30 (96.8) | 6 (19.3) | 119 (65.8) |
| No | 36 (30.2) | 1 (3.2) | 25 (80.7) | 62 (34.2) |
| I would consult a hypertension specialist: | ||||
| I would not call a hypertension specialist | 68 (59.1) | 10 (58.8) | 4 (13.8) | 82 (51.0) |
| After adjusting the dose of 1 current medication if inadequate response | 0 (0) | 1 (5.9) | 1 (3.4) | 2 (1.2) |
| After adjusting the dose of 2 current medications if inadequate response | 29 (25.2) | 4 (23.5) | 14 (48.3) | 47 (29.2) |
| After adding on one additional anti‐hypertensive medication | 13 (11.3) | 2 (11.8) | 6 (20.7) | 21 (13.0) |
| If a patient’s BP was over ___/___. (mean, SD, number responding) | 5 (4.4) | 0 (0) | 4 (13.8) | 9 (5.6) |
| How soon after discharge should patients in whom BP has required initiation or adjustment of drugs while in the hospital be seen? | ||||
| <1 week | 15 (12.6) | 10 (32.3) | 10 (32.3) | 35 (19.3) |
| 1–2 weeks | 85 (71.4) | 20 (64.5) | 21 (67.7) | 126 (69.6) |
| 3–4 weeks | 16 (13.5) | 1 (3.2) | 0 (0) | 17 (9.4) |
| >4 weeks | 3 (2.5) | 0 (0) | 0 (0) | 3 (1.7) |
| In general, for patients treated for hypertension prior to hospitalization, should they be discharged on: | ||||
| The final drug regimen established during the hospitalization | 106 (91.4) | 29 (93.6) | 27 (87.1) | 162 (91.0) |
| The drug regimen on which they were admitted | 10 (8.6) | 2 (6.4) | 4 (12.9) | 16 (9.0) |